root canal treatment - NHS and private costs & pros and cons

Toothsmith

capomeister wrote: »

I've been in the wars - got a compound fracture the day after dentist told me to leave my tooth alone. Been in hospital where tooth pain flared despite being on heavy antibiotics. So I need treatment - tooth very sensitive to any sort of pressure & cold, particulaly the former. Dreading what tooth pain will be like when heavy antibiotics course (for the fracture) ends tomorrow as my dentist can't see me till Thursday afternoon.

Dentist told me, however, that a specialist would do a much better job than her due to better equipment, incl. microscope. But she would have to refer me and it'd cost £800 at one place or £625 at another clinic. These figures shocked me. Does anyone know if these prices are reasonable/standard for RCT on a back tooth? She's also not sure I have enough tooth left for it to be crowned. In which case would it be worth it? Should I continue along the specialist route and could someone advise how to go about finding a more reasonably priced clinic? Don't mind travelling out of London to get a better price if treatment is high quality. Apart from microscope what else should I look for in a RCT clinic?

Thanks for any advice!

Prices can vary depending on practice location - high cost/low cost areas.

Specialist practices tend to be in city centres, so that they can take advantage of good transport links to a big area. But office space, and wage costs are dearer.

Those prices sound slightly higher than the prices around me - although there is one chap near here who charges more than the top quote.

I'd say they sounded about right.

capomeister

Toothsmith wrote: »

Prices can vary depending on practice location - high cost/low cost areas.

Specialist practices tend to be in city centres, so that they can take advantage of good transport links to a big area. But office space, and wage costs are dearer.

Those prices sound slightly higher than the prices around me - although there is one chap near here who charges more than the top quote.

I'd say they sounded about right.

Am told these may be prices just for RCT and not including crowning, in which case we could be at over £1,000! I live on the outskirts of London so prices shouldn't be city-centre rate. I am tempted to try the NHS again.

Toothsmith

capomeister wrote: »

Am told these may be prices just for RCT and not including crowning, in which case we could be at over £1,000! I live on the outskirts of London so prices shouldn't be city-centre rate. I am tempted to try the NHS again.

I would have guessed it was a SE sort of price. Sounds right though.

NHS will be fine if you're not that bothered about keeping the tooth - or find someone like Welshdent who does it well on the NHS!

(My guess is that he's not the dentist at his practice responsible for paying the bills though! )

capomeister

Toothsmith wrote: »

I would have guessed it was a SE sort of price. Sounds right though.

NHS will be fine if you're not that bothered about keeping the tooth - or find someone like Welshdent who does it well on the NHS!

(My guess is that he's not the dentist at his practice responsible for paying the bills though! )

I am bothered about keeping the tooth as it's my primary upper molar... but £1000 for the treatment?! There's a place in Bristol doing an implant for £600 which seems a better route to go down if NHS fails. How much more likely will a private RCT succeed over NHS done with magnifying glasses anyway?

I wish Welshdent would have me on the NHS - don't mind going to Wales to save myself £800 on SE England prices!

welshdent

Hi cap just a quickie ... this is just to try and illustrate the advantage of using a microscope ..

ROughly how things are with no scope - maybe some slight enlargement.



Left pic is a low mag view passing to higher levels of magnification with a scope.


This series shows where hidden canals may be hiding that would be almost impossible to see with the naked eye



The following picture shows the opening of 2 root canals within a tooth and a crack. The canal holes would be around about 2mm in diameter.

Seeing these things are a nightmare without a good light and magnification.


A microscope is an expensive purchase. A basic one with a lower powered light will start at around £7K but this is very much an entry level scope. Better IMO than nothing but the usage of these is not as fluid as a better spec one. To get a scope with a decent high powered light then you are looking at around £15K.
Bear in mind that the NHS doesnt pay dentists any additional money to do root fillings full stop let alone paying to shell out for this sort of gear you can maybe see why most NHS practitioners do not have this sort of thing. The NHS wont even pay for the files we need to use! Its an expensive treatment to provide folks!! I got one but thats because I am a geek frankly. I really enjoy doing these sort of treatments and view it as a long term investment in myself to better my skills. I wont be planning to replacing mine any time soon so I am taking the financial hit ... I dont enjoy it but needs must!!

Savvy_Sue

I think those photos need a health warning! :eek:

welshdent

Savvy_Sue wrote: »

I think those photos need a health warning! :eek:

welcome to my world!!! LOL

Toothsmith

capomeister wrote: »

I am bothered about keeping the tooth as it's my primary upper molar... but £1000 for the treatment?! There's a place in Bristol doing an implant for £600 which seems a better route to go down if NHS fails. How much more likely will a private RCT succeed over NHS done with magnifying glasses anyway?

I wish Welshdent would have me on the NHS - don't mind going to Wales to save myself £800 on SE England prices!

If you're prepared to go as far afield as Bristol, then you'll find cheaper private endo specialists to fill your tooth.

Implant survival rates are very good, but they're by no means a 'forever' treatment, and they will eventually fail - what happens then?

It's always best to get as long as you can from what you've got (Although in the root filling/implant debate, this really will depend on every individual case on it's merits - there will be no such thing as an 'in general' here)

But I would say that if it is felt that the root filled crowned tooth has a good chance of lasting 10+ years, then this is a good option to take before eventually replacing the tooth with an implant.

If you have the tooth badly root filled, and it fails after a few years of having a small chronic abscess still in place, then the bone quality down there might not be suitable for an implant for a little while.

capomeister

Toothsmith wrote: »

If you're prepared to go as far afield as Bristol, then you'll find cheaper private endo specialists to fill your tooth.

Implant survival rates are very good, but they're by no means a 'forever' treatment, and they will eventually fail - what happens then?

It's always best to get as long as you can from what you've got (Although in the root filling/implant debate, this really will depend on every individual case on it's merits - there will be no such thing as an 'in general' here)

But I would say that if it is felt that the root filled crowned tooth has a good chance of lasting 10+ years, then this is a good option to take before eventually replacing the tooth with an implant.

If you have the tooth badly root filled, and it fails after a few years of having a small chronic abscess still in place, then the bone quality down there might not be suitable for an implant for a little while.

Thanks for the advice Toothsmith. I just don't know where abouts to look to find a cheap endo specialist, or a dentist on the nhs with an interest in endo treatments. I think maybe to get it done on the NHS and hope to get a long life out of it and if/when that fails look at the possibilty of an implant. I agree that it'd be best to get successful RCT than an implant and I can certainly see the benefits of the microscope having seen the very graphic photos Welshdent kindly provided. But I'm shooting in the dark as have no experience or commendations to judge whether any one or the other is good. £800+ for a treatment which might fail in a short number of years is a scary thought.

Toothsmith

A specialist endodontist should give you quite an accurate assessment of the tooth's prognosis - as well as these things CAN be predicted. But he certainly wouldn't take your money if he didn't feel there was a good chance of it lasting a reasonable amount of time. And 'reasonable' when spending that sort of money should be 6-7 yrs +.